Legal and Ethical Issues -- test bank
1. Four patients in labor all request epidural analgesia to manage their pain at
the same time. Which ethical principle is compromised when only one nurse
anesthetist is on call?
a.Justice
b.Nonmaleficence
c.Beneficence
d.Fidelity: ANS: A
Justice refers to fairness and is used frequently in discussion regarding access to
health care resources. Here the just distribution of resources, in this case pain
management, cannot be justly apportioned. Nonmaleficence means do no harm,
beneficence means to do good, and fidelity means to be true to, or honest. Each of
these principles is partially expressed in the question; however, justice is most
comprised because not all laboring patients have equal access to pain management
owing to lack of personnel resources.
2. The patient tells the nurse that she is afraid to speak up regarding her
desire to end care for fear of upsetting her husband and children. Which
principle in the nursing code of ethics ensures that the nurse will promote
the patients cause?
a.Responsibility
b.Advocacy
c.Confidentiality
d.Accountability: ANS: B
Nurses advocate for patients when they support the patients cause. A nurses ability
to adequate advocate for a patient is based on the unique relationship that develops
and the opportunity to better understand the patients point of view. Responsibility
refers to respecting ones professional obligations and following through on
promises. Confidentiality deals with privacy issues, and accountability refers to
owning ones actions.
3. The patients son requests to view the documentation in his mothers
medical record. What is the nurses best response to this request?
a.Ill be happy to get that for you.
b.You will have to talk to the physician about that.
,c.You will need your mothers permission.
d.You are not allowed to see it.: ANS: C
The nurse understands that sharing health information is governed by HIPAA
legislation, which defines rights and privileges of patients for protection of privacy.
Private health information cannot be shared without the patients specific
permission. The other three responses either are outright false and/or use poor
communication techniques.
4. When people work together to solve ethical dilemmas, individuals must
examine their own values. This step is crucial to ensure that
a.The group identifies the one correct solution.
b.Fact is separated from opinion.
c.Judgmental attitudes are not provoked.
d.Different perspectives are respected.: ANS: D
Values are personal beliefs that influence opinions. To be able to negotiate
differences in opinions, the nurse must first be clear about personal values, which
will influence behaviors, decisions, and actions. Ethical dilemmas are a problem in
that no one right solution exists.
5. Ethical dilemmas are common occurrences when caring for patients.
The nurse understands that dilemmas are a result of
a.Presence of conflicting values.
b.Hierarchical systems.
c.judgmental perceptions of patients.
d.Poor communication with the patient.: ANS: A
Poor communication and the hierarchical systems that exist in health care, such as
reporting structures within the hospital or the historically unequal relationship
between physicians and nurses, may complicate dilemmas. The primary, underlying
reason that ethical dilemmas occur is that there are no clear cut, universally
accepted solutions to a problem when participating individuals do not share the
same values. Without clarification of values, the nurse may not be able to distinguish
fact from opinion or value, and this can lead to judgmental attitudes.
6. The nurse questions a physicians order to administer a placebo to the
patient. The nurses action is based on which ethical principle?
a.Autonomy
, Legal and Ethical Issues -- test bank
b.Beneficence
c.Justice
d.Fidelity: ANS: A
Autonomy refers to the freedom to make decisions free of external control. In this
case, the nurse questions the physicians order for a placebo because it supports
the patients autonomy. Although beneficence, taking a positive action for others,
has implications here, it is not the primary operating principle. Justice refers to
fairness and is most often used in discussions about access to health care
resources. Fidelity refers to the agreement to keep promises.
7. The nurse finds it difficult to care for a patient whose advance directive
states that no extraordinary resuscitation measures should be taken. Which
step may help the nurse to find resolution in this assignment?
a.Call for an ethical committee consult.
b.Decline the assignment on religious grounds.
c.Scrutinize her own personal values.
d.Convince the family to challenge the directive.: ANS: C
Values develop over time and are influenced by family, schools, religious
traditions, and life experiences. The nurse must recognize that no two humans
have the same set of experiences, and so differences in values are more likely the
norm than the exception. Closer inspection of ones values may be a step in
gaining understanding of another persons perspective. Calling for a consult,
declining the assignment, and convincing the family to challenge the patients
directive are not ideal resolutions because they do not address the reason for the
nurses discomfort, which is the conflict between the nurses values and those of
the patient.
8. The nurse values autonomy above all other principles. Which patient
assignment will the nurse find most difficult to accept?
a.Teenager in labor who requests epidural anesthesia
b.Middle-aged father of three with an advance directive declining life support
c.Elderly patient who requires dialysis
d.Family elder who is making the decisions for a 30-year-old female
member: ANS: D
Autonomy refers to freedom from external control. A person who values autonomy
highly may find it difficult to accept situations where the patient is not the primary
, decision maker regarding his or her care. A teenager requesting an epidural, a
father with an advanced directive, and an elderly patient requiring dialysis all
describe a patient or family that can make their own decisions and choices
regarding care.
9. Which philosophy of health care ethics would be particularly useful
when making ethical decisions about vulnerable populations?
a.Feminist ethics
b.Deontology
c.Bioethics
d.Utilitarianism: ANS: A
Feminist ethics particularly focuses on the nature of relationships, especially those
where there is a power imbalance or a point of view that is not routinely accepted.
Examples of populations that are considered vulnerable include children, pregnant
women, incarcerated persons, and minority groups. Deontology refers to making
decisions or right-making characteristics, bioethics focuses on consensus building,
and utilitarianism speaks to the greatest good for the greatest number.
10. A nurse argues that we need to reform our health care system because
we have a large number of people who are uninsured and end up needing
expensive emergent care when low-cost measures could have prevented
their illnesses. What ethical framework is she using to make this case?
a.Deontology
b.Ethics of care
c.Feminist ethics
d.Utilitarianism: ANS: D
Utilitarianism is a system of ethics that believes that value is determined by
usefulness. This system of ethics focuses on the outcome of the greatest good for
the greatest number of people. Deontology would not look to consequences of
actions. The ethics of care would not be helpful because consensus on this issue is
not achievable. Relationships, which are an important component of feminist ethics,
are not addressed in this case.
11. The nurse has become aware of missing narcotics in the patient care
area. Which ethical principle obligates the nurse to report the missing
medications?
a.Advocacy
1. Four patients in labor all request epidural analgesia to manage their pain at
the same time. Which ethical principle is compromised when only one nurse
anesthetist is on call?
a.Justice
b.Nonmaleficence
c.Beneficence
d.Fidelity: ANS: A
Justice refers to fairness and is used frequently in discussion regarding access to
health care resources. Here the just distribution of resources, in this case pain
management, cannot be justly apportioned. Nonmaleficence means do no harm,
beneficence means to do good, and fidelity means to be true to, or honest. Each of
these principles is partially expressed in the question; however, justice is most
comprised because not all laboring patients have equal access to pain management
owing to lack of personnel resources.
2. The patient tells the nurse that she is afraid to speak up regarding her
desire to end care for fear of upsetting her husband and children. Which
principle in the nursing code of ethics ensures that the nurse will promote
the patients cause?
a.Responsibility
b.Advocacy
c.Confidentiality
d.Accountability: ANS: B
Nurses advocate for patients when they support the patients cause. A nurses ability
to adequate advocate for a patient is based on the unique relationship that develops
and the opportunity to better understand the patients point of view. Responsibility
refers to respecting ones professional obligations and following through on
promises. Confidentiality deals with privacy issues, and accountability refers to
owning ones actions.
3. The patients son requests to view the documentation in his mothers
medical record. What is the nurses best response to this request?
a.Ill be happy to get that for you.
b.You will have to talk to the physician about that.
,c.You will need your mothers permission.
d.You are not allowed to see it.: ANS: C
The nurse understands that sharing health information is governed by HIPAA
legislation, which defines rights and privileges of patients for protection of privacy.
Private health information cannot be shared without the patients specific
permission. The other three responses either are outright false and/or use poor
communication techniques.
4. When people work together to solve ethical dilemmas, individuals must
examine their own values. This step is crucial to ensure that
a.The group identifies the one correct solution.
b.Fact is separated from opinion.
c.Judgmental attitudes are not provoked.
d.Different perspectives are respected.: ANS: D
Values are personal beliefs that influence opinions. To be able to negotiate
differences in opinions, the nurse must first be clear about personal values, which
will influence behaviors, decisions, and actions. Ethical dilemmas are a problem in
that no one right solution exists.
5. Ethical dilemmas are common occurrences when caring for patients.
The nurse understands that dilemmas are a result of
a.Presence of conflicting values.
b.Hierarchical systems.
c.judgmental perceptions of patients.
d.Poor communication with the patient.: ANS: A
Poor communication and the hierarchical systems that exist in health care, such as
reporting structures within the hospital or the historically unequal relationship
between physicians and nurses, may complicate dilemmas. The primary, underlying
reason that ethical dilemmas occur is that there are no clear cut, universally
accepted solutions to a problem when participating individuals do not share the
same values. Without clarification of values, the nurse may not be able to distinguish
fact from opinion or value, and this can lead to judgmental attitudes.
6. The nurse questions a physicians order to administer a placebo to the
patient. The nurses action is based on which ethical principle?
a.Autonomy
, Legal and Ethical Issues -- test bank
b.Beneficence
c.Justice
d.Fidelity: ANS: A
Autonomy refers to the freedom to make decisions free of external control. In this
case, the nurse questions the physicians order for a placebo because it supports
the patients autonomy. Although beneficence, taking a positive action for others,
has implications here, it is not the primary operating principle. Justice refers to
fairness and is most often used in discussions about access to health care
resources. Fidelity refers to the agreement to keep promises.
7. The nurse finds it difficult to care for a patient whose advance directive
states that no extraordinary resuscitation measures should be taken. Which
step may help the nurse to find resolution in this assignment?
a.Call for an ethical committee consult.
b.Decline the assignment on religious grounds.
c.Scrutinize her own personal values.
d.Convince the family to challenge the directive.: ANS: C
Values develop over time and are influenced by family, schools, religious
traditions, and life experiences. The nurse must recognize that no two humans
have the same set of experiences, and so differences in values are more likely the
norm than the exception. Closer inspection of ones values may be a step in
gaining understanding of another persons perspective. Calling for a consult,
declining the assignment, and convincing the family to challenge the patients
directive are not ideal resolutions because they do not address the reason for the
nurses discomfort, which is the conflict between the nurses values and those of
the patient.
8. The nurse values autonomy above all other principles. Which patient
assignment will the nurse find most difficult to accept?
a.Teenager in labor who requests epidural anesthesia
b.Middle-aged father of three with an advance directive declining life support
c.Elderly patient who requires dialysis
d.Family elder who is making the decisions for a 30-year-old female
member: ANS: D
Autonomy refers to freedom from external control. A person who values autonomy
highly may find it difficult to accept situations where the patient is not the primary
, decision maker regarding his or her care. A teenager requesting an epidural, a
father with an advanced directive, and an elderly patient requiring dialysis all
describe a patient or family that can make their own decisions and choices
regarding care.
9. Which philosophy of health care ethics would be particularly useful
when making ethical decisions about vulnerable populations?
a.Feminist ethics
b.Deontology
c.Bioethics
d.Utilitarianism: ANS: A
Feminist ethics particularly focuses on the nature of relationships, especially those
where there is a power imbalance or a point of view that is not routinely accepted.
Examples of populations that are considered vulnerable include children, pregnant
women, incarcerated persons, and minority groups. Deontology refers to making
decisions or right-making characteristics, bioethics focuses on consensus building,
and utilitarianism speaks to the greatest good for the greatest number.
10. A nurse argues that we need to reform our health care system because
we have a large number of people who are uninsured and end up needing
expensive emergent care when low-cost measures could have prevented
their illnesses. What ethical framework is she using to make this case?
a.Deontology
b.Ethics of care
c.Feminist ethics
d.Utilitarianism: ANS: D
Utilitarianism is a system of ethics that believes that value is determined by
usefulness. This system of ethics focuses on the outcome of the greatest good for
the greatest number of people. Deontology would not look to consequences of
actions. The ethics of care would not be helpful because consensus on this issue is
not achievable. Relationships, which are an important component of feminist ethics,
are not addressed in this case.
11. The nurse has become aware of missing narcotics in the patient care
area. Which ethical principle obligates the nurse to report the missing
medications?
a.Advocacy
